12.6.2. TICKLISH QUESTIONS

и        It would seem, really: unethical is to make help not quite disinterestedly, especially when it is a question of life and death. But not free of charge firemen do work, other rescuers, and just physicians too. The most near of kin (as it seems to the author) mutual relations healer÷patient and blooddonor÷recipient are. A donor receives his payment (in the USSR, and now in Russia; but not in all countries it is so) more likely not for his blood itself, but as indemnification for loss of time and for other inconveniences with which the procedure is connected. A problem is not a principle question – whether a healer has the moral right to have his fee, but a practical questions – about its amount, about the moment of its reception, etc. Certainly, everything is solved by concrete circumstances, but it is not less clear, that (in principle, always) while a healer can accept his fee, but
• he should not demand it,
• should not put preliminary financial ( or others material ) conditions to his patient;
• he should try to forgive a patient, who has remained his debtor.
    There is also an inverse side of this question. It is ticklish not only for a healer, but for a patient too. His subjective aspiration to pay off somehow (let it be not completely, and not obligatory with money) with his healer, to not remain his debtor is clear. And it is the problem, important methodologically. Everything is unstable, that is received for nothing, without the certain minimum of efforts. If a person does not wish to grow up and to bake bread himself, he has the right to buy it. If a patient does not want (or cannot) to pay with his own labor for reception (or preservation) of his health (the chapter 16 is about such possibility), he has the right to pay off differently. Just in order to force his patients to work, one of the healers who did not accept any payment from them in principle, made sometimes to them artificial small difficulties, like set a time of a session obviously inconvenient for the patient. Evidently, the majority of patients would prefer to pay off, but to have no inconveniences like this.
    In principle, a decision of this problem can be solved quite economically: to count up, how much is patient's saving owing to his healer, because of his situation changes - from minor ones (like liberation from necessity of medicines buying) and up to most serious (like liberation from necessity of an operation).
    This economy or its part, for example - a half, can become healer's fee.
    However such appraisals can be both laborious and much ambiguous. In conditions of the USSR such approach was impossible at all. It is complicated (or even quite impossible) also in the situation when sick-funds pay/compensate patient's service by the academic medicine, but not by a healer.
    It is seemed, that an optimum payment may be that is simultaneously
• quite feasible for a patient, but
• is significant, not indifferent (is not too small).
    Usually, a person hardly chooses what is significant and/or insignificant for him, what is feasible and/or excessive. He starts to hesitate, to bargain with himself. His choice can change cardinally (on orders!) subject to whether his problem must be still solved or is already solved by a healer.
    But, especially, his healer cannot make this choice instead of him.     и